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. 2012 Sep 24;1(1):30.
doi: 10.1186/2162-3619-1-30.

R-CHOP with dose-attenuated radiation therapy could induce good prognosis in gastric diffuse large B cell lymphoma

Yuko Mishima  1 , Yasuhito Terui, Masahiro Yokoyama, Noriko Nishimura, Sakura Sakajiri, Kyoko Ueda, Yasutoshi Kuboki, Kenji Nakano, Kazuhito Suzuki, Eriko Nara, Naoko Tsuyama, Kengo Takeuchi, Masahiko Oguchi, Kiyohiko Hatake
Affiliations

R-CHOP with dose-attenuated radiation therapy could induce good prognosis in gastric diffuse large B cell lymphoma

Yuko Mishima et al. Exp Hematol Oncol. .

Abstract

Background: The treatment strategy for gastric diffuse large cell lymphoma (DLBCL) has not been standardized in such as to the cycles of chemotherapy, dose of radiation, or necessity for the surgery. Although the results of CHOP or R-CHOP treatments have demonstrated the good prognosis, the treatments have been controversial in many cases.

Methods: We retrospectively analyzed 40 gastric DLBCL patients receiving chemotherapy with or without radiation in our institute. Those in stages II-IV were treated with six cycles of R-CHOP without radiation; for those in stage I, we administered three cycles of R-CHOP with radiation.

Results: The three-year overall survival (OS) and progression-free survival (PFS) rates were 95.2 and 91.8%, respectively. Those in stage I obtained 100% of OS. The radiation dose prescribed was 30.6 Gy for CR cases and 39.6 to 40 Gy for PR after chemotherapy. Although survival rates tended to correlate with staging groups or age-adjusted IPI classifications, multivariate statistical analysis did not show clear differences. All 14 patients with initial bleeding were successfully managed without surgery during treatment.

Conclusion: R-CHOP therapy was very effective for gastric DLBCL. It may be not necessary to use more than 30.6 Gy of radiotherapy in the highly chemo-sensitive cases. Less toxic treatments should be made available to gastric DLBCL patients.

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Figures

Figure 1
Figure 1
The schema of treatment of gastric DLBCL in our study.
Figure 2
Figure 2
Kaplan-Meier curve of overall survival (A) and progression free survival (B) for all patients.
Figure 3
Figure 3
Overall survival (A) and progression free survival (B) in classified with stage I,II and IV.
Figure 4
Figure 4
Overall survival (A) and progression free survival (B) in classified with aa-IPI 1-3 and 4.
See this image and copyright information in PMC

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